Analytics, precision medicine key to value-based care, but health systems struggle with funding: KLAS survey

Limited funding and lack of reimbursement from payers are the top hurdles to patient engagement technologies, analytics and precision medicine, according to a survey of chief information officers.

Healthcare providers plan to ramp up investments in telemedicine, patient portals and data aggregation capabilities but continue to struggle with how to fund these investments, a survey report from KLAS Research and the Center for Connected Medicine (CCM) found.

The "Top of Mind for Top Health Systems 2019" survey from KLAS Research and CCM surveyed 70 healthcare executives, including CIOs and IT directors, from 65 health systems.

"Health systems are moving toward a risk-based world where they will have a bigger financial stake in better managing the health of their patients. Having access to complete patient data and analyzing it, keeping patients engaged in their health and delivering more effective treatments, are essential to managing risk,” Pamela Peele, Ph.D., chief analytics officer of UPMC Health Plan and UPMC Enterprises, said in a statement.

“Finding the money to deploy these important technologies, while managing the other financial pressures health systems face, is a challenge for all health care providers,” said Peele, who is a member of the steering committee for the CCM, which is jointly operated by GE Healthcare, Nokia and UPMC.

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Here's what CIOs and other executives had to say about technology to support the shift to value-based care:

Patient engagement

Patient portals and telemedicine are the technologies most often deployed in health systems’ patient engagement efforts, with 82% of healthcare executives saying the patient portal is the dominant technology for engaging with patients.

But patient adoption of these tools is still low. Organizations report that, on average, 35% of patients have adopted the technologies that are available to them. Nearly half of executives (46%) said patients were the biggest hurdle to increased adoption of patient engagement technologies.

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Executives also say lack of reimbursement is a major challenge. Telemedicine, in particular, was called out as an area in which payer buy-in is lacking.

One healthcare IT director explained, “The biggest barrier is reimbursement. Everyone knows that it works very well, and the payers drive a lot of it, so we look at it as if there are bundled payments. That works well, but obviously, adoption rises when something is covered by insurance because people can consider convenience and cost."

Despite that, health systems are increasing their investment in patient engagement technologies, with telemedicine (80%), patient portals (70%) and remote patient monitoring (57%) cited as top investment areas.

Data analytics

Data aggregation is a top priority as health systems attempt to shift to value-based care, according to the report.

On average, organizations report they are 71% of the way to complete clinical integration and 61% of the way to full integration, which includes clinical data as well as claims, financial and other data sources, the survey found.

These data integration efforts are stymied by limited funding and resources, according to nearly half (44%) of CIOs and other executives. 

There are technical barriers as well, such as poor data normalization (44%) and lack of data standards (40%). Small healthcare organizations also reported intentional data blocking as a barrier, the report said.

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About half of survey respondents blamed health IT vendors as the most common source for data aggregation roadblocks.

According to the report, one IT director said most usable data come from "systems we have purchased from IT vendors, and it is a lack of standards and interoperability between the vendors that cause most of the problems." 

"I guess one could put payers on the list of responsible parties; part of the issue comes from their end as well," the IT director said.

Precision medicine

According to the survey, there is tremendous optimism in the potential of precision medicine. However, reimbursement and generating a return on investment are significant challenges, CIOs surveyed said.

Barriers to entry are high, and, so far, adoption of precision medicine technology is currently limited to relatively few organizations—only 12% of interviewed health systems, mostly larger organizations, can be categorized as mature in their precision medicine efforts, the report said. 

On average, those organizations have adopted three use cases, with oncology being the most prevalent.

Getting payers to reimburse precision medicine and earning a return on investment were cited as the biggest hurdles. Currently, precision medicine is funded primarily through fee-for-service or out-of-pocket payments.

But many executives expect this to shift in a big way, along with the industry’s shift to value-based care. Almost three-quarters of respondents (73%) expect value-based payments to be the primary payment model for precision medicine treatments in two years.

According to the report, one healthcare CIO said, "I am optimistic that payers will recognize the value of pharmacogenetic testing and increase coverage of that testing. Payers should at least do that for certain disease states and medical services."